Seasonal Influenza Vaccination Recommendations from ACIP

Doctor administering vaccine
Doctor administering vaccine
Updates to the 2015-2016 influenza season guidelines include a statement on the use of the live attenuated influenza vaccine.

The Advisory Committee on Immunization Practices (ACIP) has released their recommendations on immunization practices for the 2016-2017 influenza season.

The recommendation, prepared by Lisa A. Grohskopf, MD, of the National Center for Immunization and Respiratory Diseases, Influenza Division, and colleagues from the ACIP Influenza Work Group, serves as an update to the 2015-2016 ACIP guidelines regarding the use of seasonal influenza vaccines.

Dr Grohskopf and colleagues reported that, for the 2016-2017 influenza season, inactivated influenza vaccines (IIVs) will be available to physicians in both trivalent (IIV3) and quadrivalent (IIV4) formulations; recombinant influenza vaccine (RIV) will also be available in trivalent formulation (RIV3).

The 2016-2017 trivalent influenza vaccine virus strains will include an A/California/7/2009 (H1N1)-like virus, an A/Hong Kong/4801/2014 (H3N2)-like virus, and a B/Brisbane/60/2008-like virus (Victoria lineage). Quadrivalent vaccines will include an additional B/Phuket/3073/2013-like virus (Yamagata lineage) strain.

“In light of concerns regarding low effectiveness against influenza A(H1N1)pdm09 in the United States during the 2013-2014 and 2015-2016 seasons, for the 2016-2017 season, ACIP makes the interim recommendation that live attenuated influenza vaccine (LAIV4) should not be used,” Dr Grohskopf noted.

Additional changes to the current recommendations include usage guidelines for the newly-licensed MF59-adjuvanted trivalent inactivated influenza vaccine (AIIV3), indicated for persons 65 years of age and older, and a quadrivalent formulation of Flucelvax (ccIIV4) for persons younger than 4 years of age.

Egg allergy recommendations have also been modified, including lowering the suggested 30 minute post-vaccination observation of egg-allergic vaccine recipients to 15 minutes. Additionally, all persons with egg allergies should be vaccinated under the supervision of a healthcare provider.

Dr Groshkopf and colleagues also noted that in situations where vaccine supply is limited, special focus should be placed on delivering vaccines to at-risk patients without contraindications, including children between 6 months and 4 years of age, adults 50 years of age or older, adults and children with chronic pulmonary, cardiovascular, renal, hepatic, neurologic, hematologic, or metabolic disorders; persons with immunosuppression, and women who are or will be pregnant during the influenza season.

“Although most persons who become infected with influenza viruses will recover without sequelae, influenza can cause serious illness and death,” Dr Groshkopf concluded. “Routine annual influenza vaccination of all persons aged ≥6 months without contraindications continues to be recommended.”

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Grohskopf LA, Sokolow LZ, Broder KR, et al. Prevention and control of seasonal influenza vaccines. Recommendations of the Advisory Committee on Immunization Practices – United States, 2016-17 influenza season. MMWR Recomm Rep. 2016;65(No. RR-5):1-54.  doi: 10.15585/mmwr.rr6505a1.